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General NPI Number Information
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NPI Number | 1255299947
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Entity Type | Individual
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Provider Name | MS. WILSONIA LEE SMITH
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 715 PEACHTREE ST NE STE 100&200
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City | ATLANTA
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State | GA
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Zip | 30308-2177
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Country | US
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Telephone | 646-941-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 5256 ADAGIO LN
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City | LAKELAND
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State | TN
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Zip | 38002-6009
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Country | US
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Telephone | 901-603-1909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW002598
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License Number State | GA
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